Medical Informatics


Although a number of medical decision-support systems have been developed, little attention has been given to effective delivery of expert information to medical personnel involved in patient-centered activities such as trauma care. TraumAID is a decision support system for addressing the initial definitive management of emergency center trauma care; it was developed by researchers at the University of Pennsylvania and the Medical College of Pennsylvania. In research with these colleagues and Terry Harvey, we have been investigating how information might be delivered so that it has the greatest positive impact on patient care. Our analysis of critiques produced by the critiquing module associated with the TraumAID decision support system showed that while each critique was coherent in isolation, the critiques as a whole exhibit informational overlap and incoherence. To address this problem, we developed a message planner that takes the text plans for an arbitrary but inter-related set of communicative goals and produces a concise and coherent integrated message. The message planner addresses the problems of informational overlap in the original text plans and the appearance of conflict between text plans, and exploits relations between text plans to enhance coherence. Although the original text planner (TraumaGEN) was domain-dependent, our new text planner (RTPI) utilizes domain-independent rules along with adjustable parameters that determine when and how rules are invoked.

The second component of our medical informatics research is concerned with exploiting the extensive knowledge bases in decision support systems. We constructed TraumaCASE, a system that does reverse-chaining on the TraumAID rules and accesses knowledge stored in the TraumAID knowledge base to automatically construct realistic clinical cases of varying levels of difficulty. Such cases can be used for instructional purposes by a training module or for recertification exams by a quality assurance module. Automatic case generation eliminates the need to collect and pre-store a library of cases and reduces the likelihood that a selected cases replicates one used previously.

Relevant Publications

(with B. Webber, J. R. Clarke, A. Gertner, T. Harvey, R. Rymon, and R. Washington) Exploiting Multiple Goals and Intentions in Decision Support for the Management of Multiple Trauma: A Review of the TraumAID Project. Artificial Intelligence Journal, 105(1-2), pp. 263-293, 1998. (gzipped postscript paper) x

(with T. Harvey) Integrating Text Plans for Conciseness and Coherence. Proceedings of the 36th Annual Meeting of the Association for Computational Linguistics and the 17th International Conference on Computational Linguistics (ACL-COLING), pp. 512-518, 1998.

(with T. Harvey and J. R. Clarke M.D.) Integrating Communicative Goals for Real-time Clinical Decision Support. Proceedings of the American Medical Informatics Association Annual Fall Symposium (AMIA), pp. 734-738, 1997.

(with T. Harvey) Generating Coherent Messages in Real-time Decision Support: Exploiting Discourse Theory for Discourse Practice. Proceedings of the Nineteenth Annual Conference of the Cognitive Science Society, pp. 79-84, 1997. (postscript paper)

(with J. R. Clarke M.D.) TraumaCASE: Exploiting the Knowledge Base of an Existing Decision Support System to Automatically Construct Medical Cases. Proceedings of the Tenth International Symposium on Methodologies for Intelligent Systems (ISMIS), pp. 456-466, 1997.

(with J. R. Clarke M.D.) Generating Clinical Exercises of Varying Difficulty. Proceedings of the Sixth International Conference on User Modeling (UM-97), pp. 273-275, 1997.

(with J. R. Clarke M.D. and A. Gertner) Automatic Construction of Medical Cases for Training and Testing Using the Knowledge Base of an Existing Decision Support System. Proceedings of the AAAI Spring Symposium on Artificial Intelligence in Medicine, pp. 16-20, 1996.

Last updated: Sept. 10, 1998
carberry@cis.udel.edu

Back to my homepage.